Now that we've raised alarms over lithium toxicity, M-A-O-I interactions, and Lomotrogen rash,

we're going to change course with a final commandment that reminds us what psychopharmacology is really all about.

Welcome to the Carlyte Psychiatry Podcast, keeping psychiatry honest since 2003. I'm Chris Aiken, the editor-in-chief of the Carlet Psychiatry podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlet Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

We are ready to close the book on this series with the final 10th commandment,

one that puts the first nine in perspective.

But first, let's recap.

1. Do not worsen mental illness with psychiatric medications, like don't use antidepressants in

mania or psychostimulants in psychosis. Two, avoid stopping meds abruptly, particularly benzodiazepines, serotonergics, and lithium.

3. Prevent lithium toxicity by checking interactions, age and renal function.

4. Stop Lomotrogen if any rash develops in the first three months.

5. Do not combine benzodiazepines and opioids in patients at high risk for overdose death.

Six, honor thy M-A-O-I interactions, but get up to date on the new diet data.

7.

Controlled substances shall be controlled by you.

8.

Avoid unwise medication combos like benzos and stimulants, or stimulants and antipsychotics.

Nine, avoid Valproate, Depakote, in pregnancy.

Today, we end with number 10.

Do not avoid effective medications just because they carry risks.

This commandment is going to uncover a paradox in psychiatry.

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